Global implications of diabetes biomedicalization

Abstract Diabetes remains one of the leading causes of death globally, with its prevalence and associated costs rising despite advances in pharmaceuticals and biomedical technologies. This paper offers a critical, conceptual analysis of how biomedical technologies are reshaping diabetes care by expanding treatment and risk categories associate with type 1 diabetes and prediabetes. Drawing from science and technology studies and critical public health perspectives, the paper uses two illustrative examples, Tzield, an FDA-approved pharmaceutical designed to delay the onset of symptomatic type 1 diabetes, and Continuous Blood Glucose Monitors (CGMs), increasingly used by individuals without a diabetes diagnosis, to examine how biomedical interventions target populations deemed “at risk.” The paper analyzes these technologies as examples of a broader trend: the biomedicalization of risk and the expansion of pharmaceutical and device markets into pre-diagnostic states. It introduces the concept of the “diabetes paradox” to underscore how the exploitation of risk perception in diabetes care may inadvertently undermine the intended benefits of new treatments. It demonstrates that shifting perceptions of risk not only create new burdens and afflictions but also broaden the definition of “at-risk” populations. Furthermore, the paper discusses the global implications of biomedicalization that focus on future risk mitigation rather than addressing current global health challenges.